Olumacostat glasaretil Acetyl-CoA carboxylase (ACC) inhibitor Acne therapy

Acne vulgaris is a common dermatologic condition affecting adolescents and adults. Systemic and topical therapies have been developed to target different mechanisms in the pathogenesis of acne. Olumacostat glasaretil (OG) is a novel topical agent that targets sebum production in the treatment of acne vulgaris. OG's active metabolite acts as a competitive inhibitor of the rate-limiting enzyme of fatty acid synthesis, acetylcoenzyme A (CoA) carboxylase (ACC). ACC catalyzes malonylCoA formation and sebum production. OG is efficacious in the treatment of acne vulgaris and has a low side effect profile. Phase IIa and IIb trials note side effects including applicationsite erythema and dryness, and nasopharyngitis. Phase III trials are currently underway. The new mechanism of action of OG is sensible, attractive and exciting, but the available data do not demonstrate that it provides a quantum leap forward over existing therapies.